2. Heart Failure
◦ Chronic
◦ Affects 1% of the Western population 1
◦ Therapy limited due to lack of donor hearts
Stem cells considered for therapeutic use
◦ Therapy aims to repopulate damaged cardiac tissue
with regenerative cells
3. Systemic literature review
◦ Publications investigated advancement of stem cell
therapy in congestive heart failure
Randomized, Controlled Trials2
◦ Selected from three databases
◦ Combined to form a narrative summary
4. Totipotent Embryonic Stem Cells
◦ Derived from blastocysts
◦ Used to generate functional cells in animal and
human models
◦ Ethical controversy
Adult Bone Marrow Derived Stem Cells
◦ Less potent self-renewal ability
5. Three methods in generation of new
cardiomyocytes from fibroblasts3
1. Full reprogramming of fibroblasts into induced
pluripotent stem cells (iPS) and further cardiac
differentiation
2. Partial reprogramming of fibroblasts into cardiac
progenitor cells and thus further differentiation
3. Direct reprogramming of fibroblasts into
cardiomyocytes
6. Stem cells have been proven to4
◦ Improve ejection fraction
◦ Decrease diameter of infarct size
◦ Reduce amount of residual blood in left ventricular
post-systole
◦ Improve ventricular operation
7. Gunduz E, Akay O, Birdane A, Gulbas Z. Stem cell therapy for
congestive heart failure. Journal of Stem Cells & Regenerative Medicine.
2011; 7(2): 87–8
8. Stem cells has proven to be beneficial in
decreasing mortality in CHF
Improve Quality of life
Increase chances of survival
We have to overcome the limitations and
constraints
Potential for rejection
Unknown long term side effects
9.
1: Michler R. Stem Cell Therapy for Heart Failure. Methodist DeBakey
Cardiovascular Journal. 2013; 9(4): 187–194.
2: Angelini P, Markwald R. Stem Cell Treatment of the Heart: A Review
of Its Current Status on the Brink of Clinical Experimentation. Texas
Heart Institute Journal / from the Texas Heart Institute of St. Luke’s
Episcopal Hospital, Texas Children’s Hospital. 2005; 32(4): 479–488.
3: Yamakawa H, Leda M. Strategies for heart regeneration: approaches
ranging from induced pluripotent stem cells to direct cardiac
reprogramming. International Heart Journal. 2015; 56(1): 1-5. DOI:
10.1536/ihj.
4: Gunduz E, Akay O, Birdane A, Gulbas Z. Stem cell therapy for
congestive heart failure. Journal of Stem Cells & Regenerative Medicine.
2011; 7(2): 87–8